756-P: Glucagon-Like Peptide-1 Receptor Agonists and the Risk of Endoscopy Failure or Aspiration-A Cohort Study

Introduction & Objective: Several cases of aspiration during endoscopy have been reported in glucagon-like peptide-1 receptor agonists (GLP1RA) users due to residual gastric contents. We conducted a population-based cohort study to assess whether GLP1RA use, compared to sodium-glucose cotransporter 2 inhibitors (SGLT2i), is associated with an increased risk of endoscopy discontinuation or aspiration. Methods: Using two insurance claim databases, we identified adults with type 2 diabetes who underwent an endoscopy and were on either GLP1RA or SGLT2i within 30 days before the procedure. Outcomes were discontinued procedure, aspiration, or intubation, occurring within 24 hours after endoscopy. We estimated the risk ratio (RR) after 1:1 propensity score (PS) matching. Results: We identified 29,384 PS-matched pairs (mean age 61 years; 52% female). Among GLP1RA users, the risk/1000 patients was 14.4 for procedure discontinuation, 2.5 for aspiration, and 2.9 for intubation. Compared to SGLT2i, GLP1RA use was associated with a slightly higher risk of endoscopy discontinuation (RR=1.25; 95% CI=1.09-1.44) and no increased risk of aspiration or intubation. Conclusion: In this study, we observed no association between GLP1RA use and aspiration or intubation during endoscopy; however, GLP1RA users were more likely to have the procedure discontinued, compared to patients on SGLT2i.